{"id":"https://openalex.org/W4379472467","doi":"https://doi.org/10.3389/fped.2023.1157542","title":"Pediatric antibiotic stewardship programs in Europe: a pilot survey among delegates of The European Academy of Pediatrics","display_name":"Pediatric antibiotic stewardship programs in Europe: a pilot survey among delegates of The European Academy of Pediatrics","publication_year":2023,"publication_date":"2023-06-05","ids":{"openalex":"https://openalex.org/W4379472467","doi":"https://doi.org/10.3389/fped.2023.1157542","pmid":"https://pubmed.ncbi.nlm.nih.gov/37342529","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/10277725"},"language":"en","primary_location":{"id":"doi:10.3389/fped.2023.1157542","doi":"https://doi.org/10.3389/fped.2023.1157542","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fped.2023.1157542","pdf_url":"https://www.frontiersin.org/articles/10.3389/fped.2023.1157542/pdf","source":{"id":"https://openalex.org/S2596117549","display_name":"Frontiers in Pediatrics","issn_l":"2296-2360","issn":["2296-2360"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-scientific","cwts-core","doaj","norway-1","poland-70","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Pediatrics","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://www.frontiersin.org/articles/10.3389/fped.2023.1157542/pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5000976831","display_name":"Stephen M. Reingold","orcid":"https://orcid.org/0000-0002-1580-2204","observed_orcids":["https://orcid.org/0000-0002-1580-2204"]},"institutions":[{"id":"https://openalex.org/I4387153156","display_name":"Kupat Holim Meuchedet","ror":"https://ror.org/04w838r82","country_code":"IL","type":"healthcare","lineage":["https://openalex.org/I4387153156"]}],"countries":["IL"],"is_corresponding":true,"raw_author_name":"Stephen M. Reingold","raw_affiliation_strings":["Department of Pediatrics, Meuhedet Health Maintenance Organization, Tel Aviv, Israel"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Pediatrics, Meuhedet Health Maintenance Organization, Tel Aviv, Israel","institution_ids":["https://openalex.org/I4387153156"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5081660653","display_name":"Zachi Grossman","orcid":"https://orcid.org/0000-0002-0656-884X","observed_orcids":["https://orcid.org/0000-0002-0656-884X"]},"institutions":[{"id":"https://openalex.org/I28185974","display_name":"Maccabi Healthcare Services","ror":"https://ror.org/04k1f6611","country_code":"IL","type":"healthcare","lineage":["https://openalex.org/I28185974"]},{"id":"https://openalex.org/I52170813","display_name":"Ariel University","ror":"https://ror.org/03nz8qe97","country_code":"IL","type":"education","lineage":["https://openalex.org/I52170813"]}],"countries":["IL"],"is_corresponding":false,"raw_author_name":"Zachi Grossman","raw_affiliation_strings":["Adelson School of Medicine, Ariel University, Ariel, Israel","Department of Pediatrics, Maccabi Health Services, Tel Aviv, Israel"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Adelson School of Medicine, Ariel University, Ariel, Israel","institution_ids":["https://openalex.org/I52170813"]},{"raw_affiliation_string":"Department of Pediatrics, Maccabi Health Services, Tel Aviv, Israel","institution_ids":["https://openalex.org/I28185974"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5079469979","display_name":"Adamos Hadjipanayis","orcid":"https://orcid.org/0000-0003-4337-3176","observed_orcids":["https://orcid.org/0000-0003-4337-3176"]},"institutions":[{"id":"https://openalex.org/I201118511","display_name":"European University Cyprus","ror":"https://ror.org/04xp48827","country_code":"CY","type":"education","lineage":["https://openalex.org/I201118511"]}],"countries":["CY"],"is_corresponding":false,"raw_author_name":"Adamos Hadjipanayis","raw_affiliation_strings":["Department of Paediatrics, Larnaca General Hospital, Larnaca, Cyprus","Medical School, European University Cyprus, Nicosia, Cyprus"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Paediatrics, Larnaca General Hospital, Larnaca, Cyprus","institution_ids":[]},{"raw_affiliation_string":"Medical School, European University Cyprus, Nicosia, Cyprus","institution_ids":["https://openalex.org/I201118511"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5020441100","display_name":"Stefano del Torso","orcid":"https://orcid.org/0000-0002-1903-7458","observed_orcids":["https://orcid.org/0000-0002-1903-7458"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Stefano Del Torso","raw_affiliation_strings":["Department of Pediatrics, ChildCare WorldWide-CCWWItalia OdV, Padova, Italy"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Pediatrics, ChildCare WorldWide-CCWWItalia OdV, Padova, Italy","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5084954332","display_name":"Ar\u016bnas Valiulis","orcid":"https://orcid.org/0000-0002-0287-9915","observed_orcids":["https://orcid.org/0000-0002-0287-9915"]},"institutions":[{"id":"https://openalex.org/I173212132","display_name":"Vilnius University","ror":"https://ror.org/03nadee84","country_code":"LT","type":"education","lineage":["https://openalex.org/I173212132"]}],"countries":["LT"],"is_corresponding":false,"raw_author_name":"Arunas Valiulis","raw_affiliation_strings":["Clinic of Children's Diseases, Institute of Clinical Medicine, Medical Faculty of Vilnius University, Vilnius, Lithuania","Human Ecology Research Group, Department of Public Health, Institute of Health Sciences, Medical Faculty of Vilnius University, Vilnius, Lithuania"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Clinic of Children's Diseases, Institute of Clinical Medicine, Medical Faculty of Vilnius University, Vilnius, Lithuania","institution_ids":["https://openalex.org/I173212132"]},{"raw_affiliation_string":"Human Ecology Research Group, Department of Public Health, Institute of Health Sciences, Medical Faculty of Vilnius University, Vilnius, Lithuania","institution_ids":["https://openalex.org/I173212132"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5042295704","display_name":"\u0141ukasz Dembi\u0144ski","orcid":"https://orcid.org/0000-0001-8299-9337","observed_orcids":["https://orcid.org/0000-0001-8299-9337"]},"institutions":[{"id":"https://openalex.org/I268303160","display_name":"Medical University of Warsaw","ror":"https://ror.org/04p2y4s44","country_code":"PL","type":"education","lineage":["https://openalex.org/I268303160"]}],"countries":["PL"],"is_corresponding":false,"raw_author_name":"Lukasz Dembinski","raw_affiliation_strings":["Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland","institution_ids":["https://openalex.org/I268303160"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5011966862","display_name":"Shai Ashkenazi","orcid":"https://orcid.org/0000-0001-7244-0679","observed_orcids":["https://orcid.org/0000-0001-7244-0679"]},"institutions":[{"id":"https://openalex.org/I52170813","display_name":"Ariel University","ror":"https://ror.org/03nz8qe97","country_code":"IL","type":"education","lineage":["https://openalex.org/I52170813"]}],"countries":["IL"],"is_corresponding":false,"raw_author_name":"Shai Ashkenazi","raw_affiliation_strings":["Adelson School of Medicine, Ariel University, Ariel, Israel"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Adelson School of Medicine, Ariel University, Ariel, Israel","institution_ids":["https://openalex.org/I52170813"]}]}],"institutions":[],"countries_distinct_count":4,"institutions_distinct_count":6,"corresponding_author_ids":["https://openalex.org/A5000976831"],"corresponding_institution_ids":["https://openalex.org/I4387153156"],"apc_list":{"value":3295,"currency":"USD","value_usd":3295},"apc_paid":{"value":3295,"currency":"USD","value_usd":3295},"fwci":1.5407,"has_fulltext":true,"cited_by_count":8,"citation_normalized_percentile":{"value":0.80180082,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":88,"max":97},"biblio":{"volume":"11","issue":null,"first_page":"1157542","last_page":"1157542"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10897","display_name":"Antibiotic Use and Resistance","score":1.0,"subfield":{"id":"https://openalex.org/subfields/2725","display_name":"Infectious Diseases"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10897","display_name":"Antibiotic Use and Resistance","score":1.0,"subfield":{"id":"https://openalex.org/subfields/2725","display_name":"Infectious Diseases"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11080","display_name":"Surgical site infection prevention","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10147","display_name":"Antibiotic Resistance in Bacteria","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2726","display_name":"Microbiology (medical)"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/antimicrobial-resistance","display_name":"antimicrobial resistance","score":0.9940000176429749},{"id":"https://openalex.org/keywords/rational-antibiotic-use","display_name":"rational antibiotic use","score":0.9369999766349792},{"id":"https://openalex.org/keywords/antimicrobial-use-surveillance","display_name":"antimicrobial use surveillance","score":0.527999997138977},{"id":"https://openalex.org/keywords/resistance-surveillance","display_name":"resistance monitoring","score":0.5929999947547913},{"id":"https://openalex.org/keywords/europe","display_name":"Europe","score":0.3269999921321869}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.8279640674591064},{"id":"https://openalex.org/C2909355912","wikidata":"https://www.wikidata.org/wiki/Q15756717","display_name":"Pediatric Infectious Disease","level":2,"score":0.7063708305358887},{"id":"https://openalex.org/C2776040555","wikidata":"https://www.wikidata.org/wiki/Q19903321","display_name":"Antimicrobial stewardship","level":4,"score":0.6272700428962708},{"id":"https://openalex.org/C512399662","wikidata":"https://www.wikidata.org/wiki/Q3505712","display_name":"Family medicine","level":1,"score":0.5463576316833496},{"id":"https://openalex.org/C2911146124","wikidata":"https://www.wikidata.org/wiki/Q19903321","display_name":"Antibiotic Stewardship","level":4,"score":0.475869357585907},{"id":"https://openalex.org/C94665300","wikidata":"https://www.wikidata.org/wiki/Q63391344","display_name":"Antibiotic resistance","level":3,"score":0.4427223801612854},{"id":"https://openalex.org/C524204448","wikidata":"https://www.wikidata.org/wiki/Q788926","display_name":"Infectious disease (medical specialty)","level":3,"score":0.4354827404022217},{"id":"https://openalex.org/C187212893","wikidata":"https://www.wikidata.org/wiki/Q123028","display_name":"Pediatrics","level":1,"score":0.40355950593948364},{"id":"https://openalex.org/C2779134260","wikidata":"https://www.wikidata.org/wiki/Q12136","display_name":"Disease","level":2,"score":0.27430468797683716},{"id":"https://openalex.org/C501593827","wikidata":"https://www.wikidata.org/wiki/Q12187","display_name":"Antibiotics","level":2,"score":0.2663939893245697},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.10129386186599731},{"id":"https://openalex.org/C86803240","wikidata":"https://www.wikidata.org/wiki/Q420","display_name":"Biology","level":0,"score":0.0},{"id":"https://openalex.org/C89423630","wikidata":"https://www.wikidata.org/wiki/Q7193","display_name":"Microbiology","level":1,"score":0.0}],"mesh":[],"locations_count":4,"locations":[{"id":"doi:10.3389/fped.2023.1157542","doi":"https://doi.org/10.3389/fped.2023.1157542","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fped.2023.1157542","pdf_url":"https://www.frontiersin.org/articles/10.3389/fped.2023.1157542/pdf","source":{"id":"https://openalex.org/S2596117549","display_name":"Frontiers in Pediatrics","issn_l":"2296-2360","issn":["2296-2360"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-scientific","cwts-core","doaj","norway-1","poland-70","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Pediatrics","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:10277725","doi":null,"is_oa":true,"landing_page_url":"https://www.ncbi.nlm.nih.gov/pmc/articles/10277725","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC10277725/pdf/fped-11-1157542.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Front Pediatr","raw_type":"Text"},{"id":"pmid:37342529","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/37342529","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in pediatrics","raw_type":"Journal Article"},{"id":"pmh:oai:doaj.org/article:e76eb7a5c3a6425eb2a8fd7faaea70b2","doi":null,"is_oa":true,"landing_page_url":"https://doaj.org/article/e76eb7a5c3a6425eb2a8fd7faaea70b2","pdf_url":null,"source":{"id":"https://openalex.org/S4306401280","display_name":"DOAJ (DOAJ: Directory of Open Access Journals)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-sa","license_id":"https://openalex.org/licenses/cc-by-sa","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Frontiers in Pediatrics, Vol 11 (2023)","raw_type":"article"}],"best_oa_location":{"id":"doi:10.3389/fped.2023.1157542","doi":"https://doi.org/10.3389/fped.2023.1157542","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fped.2023.1157542","pdf_url":"https://www.frontiersin.org/articles/10.3389/fped.2023.1157542/pdf","source":{"id":"https://openalex.org/S2596117549","display_name":"Frontiers in Pediatrics","issn_l":"2296-2360","issn":["2296-2360"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-scientific","cwts-core","doaj","norway-1","poland-70","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Pediatrics","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":1.0,"display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/observational-study","display_name":"Observational Study"}],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W4379472467.pdf","grobid_xml":"https://content.openalex.org/works/W4379472467.grobid-xml"},"referenced_works_count":18,"referenced_works":["https://openalex.org/W1577065815","https://openalex.org/W2102216674","https://openalex.org/W2128662205","https://openalex.org/W2141172032","https://openalex.org/W2602439236","https://openalex.org/W2912293410","https://openalex.org/W2957680678","https://openalex.org/W2998803677","https://openalex.org/W3029195326","https://openalex.org/W3048804624","https://openalex.org/W3104544640","https://openalex.org/W3115735690","https://openalex.org/W3127939954","https://openalex.org/W3130896579","https://openalex.org/W3137097841","https://openalex.org/W4206677002","https://openalex.org/W4213420153","https://openalex.org/W4283391025"],"related_works":["https://openalex.org/W4224849982","https://openalex.org/W3048804624","https://openalex.org/W1968064562","https://openalex.org/W2998803677","https://openalex.org/W2058224176","https://openalex.org/W2337077240","https://openalex.org/W4315781115","https://openalex.org/W4318203712","https://openalex.org/W4290630573","https://openalex.org/W4304892908"],"abstract_inverted_index":{"Background:":[0],"Antimicrobial":[1],"resistance":[2,262],"(AMR)":[3],"is":[4,43],"one":[5],"of":[6,10,21,29,46,59,90,94,102,224,246,257,275],"the":[7,18,34,44,56,91,100,106,110,115,119,130,193,201,220,225,247],"leading":[8],"causes":[9],"morbidity":[11],"and":[12,23,65,76,112,121,147,159,187,206,216,240,255,261,272,291],"mortality":[13],"worldwide.":[14],"Efforts":[15],"to":[16,39,54,72,298],"promote":[17],"judicious":[19],"use":[20,78,259],"antibiotics":[22],"contain":[24],"AMR":[25],"are":[26,305],"a":[27,67],"priority":[28],"several":[30],"medical":[31,241],"organizations,":[32],"including":[33],"WHO.":[35],"One":[36],"effective":[37],"way":[38],"achieve":[40],"this":[41],"goal":[42],"deployment":[45],"antibiotic":[47,77,126,258,277],"stewardship":[48],"programs":[49,149,252],"(ASPs).":[50],"This":[51],"study":[52],"aimed":[53],"survey":[55,84,98],"current":[57],"situation":[58],"pediatric":[60,74,103,139,164,248,282,301],"ASPs":[61,75,104,140,197,249,283,302],"in":[62,79,105,109,118,143,150,156,169,285],"European":[63,92,287],"countries":[64,108,172],"establish":[66],"baseline":[68],"for":[69,162,176],"future":[70],"attempts":[71],"harmonize":[73,299],"Europe.":[80],"Methods:":[81],"A":[82],"web-based":[83],"was":[85],"conducted":[86],"among":[87],"national":[88,202],"delegates":[89,133],"Academy":[93],"Paediatrics":[95],"(EAP).":[96],"The":[97],"assessed":[99],"presence":[101],"representatives'":[107],"inpatient":[111],"outpatient":[113,148],"settings,":[114],"staff":[116],"included":[117,250],"programs,":[120],"their":[122,157,289],"detailed":[123],"activities":[124,292],"regarding":[125],"use.":[127],"Results:":[128],"Of":[129],"41":[131],"EAP":[132],"surveyed,":[134],"27":[135],"(66%)":[136],"responded.":[137],"Inpatient":[138],"were":[141,167,198,219],"reported":[142,199],"74%":[144],"(20/27)":[145],"countries,":[146,288],"48%":[151],"(13/27),":[152],"with":[153,174,211,266],"considerable":[154],"variability":[155],"composition":[158,290],"activities.":[160],"Guidelines":[161],"managing":[163],"infectious":[165,212,233],"diseases":[166],"available":[168],"nearly":[170],"all":[171],"(96%),":[173,179],"those":[175],"neonatal":[177],"infections":[178,191],"pneumonia":[180],"(93%),":[181],"urinary":[182],"tract":[183],"(89%),":[184],"peri-operative":[185],"(82%),":[186],"soft":[188],"tissue":[189],"(70%)":[190,260],"being":[192],"most":[194,221,286],"common.":[195],"Pediatric":[196],"at":[200],"(63%),":[203],"institutional":[204],"(41%),":[205],"regional/local":[207],"(<15%)":[208],"levels.":[209],"Pediatricians":[210],"disease":[213],"training":[214],"(62%)":[215],"microbiologists":[217],"(58%)":[218],"common":[222],"members":[223],"program":[226],"personnel,":[227],"followed":[228],"by":[229],"physician":[230],"leaders":[231],"(46%),":[232],"disease/infection":[234],"control":[235],"physicians":[236],"(39%),":[237],"pharmacists":[238],"(31%),":[239],"director":[242],"representatives":[243],"(15%).":[244],"Activities":[245],"educational":[251],"(85%),":[253],"monitoring":[254],"reporting":[256],"(67%),":[263],"periodic":[264],"audits":[265],"feedback":[267],"(44%),":[268,271],"prior":[269],"approval":[270],"post-prescription":[273],"review":[274],"selected":[276],"agents":[278],"(33%).":[279],"Conclusion:":[280],"Although":[281],"exist":[284],"vary":[293],"considerably":[294],"across":[295,303],"countries.":[296],"Initiatives":[297],"comprehensive":[300],"Europe":[304],"needed.":[306]},"counts_by_year":[{"year":2026,"cited_by_count":3},{"year":2025,"cited_by_count":4},{"year":2024,"cited_by_count":1}],"updated_date":"2026-10-30T12:39:25.321706","created_date":"2023-06-07T00:00:00"}